60岁以上人群骨质疏松性骨折发病特点及转归分析

Onset Characteristics and Prognosis of Osteoporotic Fracture in the Elderly over 60

目的探索老年人骨质疏松性骨折临床特点,为骨质疏松性骨折的防治提供理论依据。方法回顾性分析复旦大学附属华山医院2010年1月1日至2014年12月31日期间60岁及以上老年人骨质疏松性髋部、椎体、腕部及肱骨近端骨折住院患者的临床资料共651例,并对手术患者术后3年内的一般情况进行跟踪随访。结果共调查患者651例,女性476例,男性175例,女性病例数为男性的2.72倍。平均年龄为(76.87±9.06)岁,男性(77.90±8.85)岁,高于女性的(76.49±9.12)岁。男女性患者骨折发病的年龄高峰均为80-89岁。骨折部位包括髋部448例(68.8%)、椎体骨折61例(9.4%)。单侧骨折中,左侧共有317例(53.9%),多于右侧271例(46.1%)。致伤原因以跌倒为主(73.11)%,致伤地点以居家为主(60.48%),好发季节为秋季(25.8%)。手术治疗率为88.3%(575例),手术治疗的有效(痊愈+好转)率为99.6%。术后3年内随访329例,再骨折24例,因各种原因死亡56例(21.2%)结论老年人骨质疏松性骨折患者女性多发,致伤原因以跌倒为主,致伤地点以居家为主,手术治疗率高。对手术后患者及家属需进行必要的健康宣教,帮助患者骨折的愈合以及预防骨折的再发生。

Objective To explore the clinical characteristics of osteoporotic fracture in the elderly.Methods Aretrospective analysis was made to the clinical data of651elderly with hip,vertebral,wrist or proximal humerus osteoporotic fractures hospitalized during the period from Jan.1,2010to Dec.31,2014as well as to the follow-up information of the first3years after operation.Results In total,651cases were enrolled,476female and175male,the ratio of male to female was1:2.5;the average age was(76.87±9.06)while that of male(77.90±8.85)was older than that of female(76.49±9.12);the onset peak age of male and female was80to89;fracture occurred in hip in448cases(68.8%),in vertebrae in61cases(9.4%);more unilateral fractures occurred on the left side than on the right side(317cases vs271cases,53.9%vs46.1%),more than the cases on the right side;73.11%fracture were caused by falling while60.48%occurred at home;the occurrence was higher in autumn(25.8%);surgical treatment rate was88.3%(575cases)and the effective rate was99.6%;during the3-year postoperative follow-up of329cases,24cases had fracture again and56cases died due to different causes.Conclusions Female elderly are like to have osteoporotic fractures mainly caused by falling,often at home;the surgical treatment rate is high;health education to patients and their family members is of certain help in the healing and the prevention of fractures again.